Lower prostate cancer survival among culturally and linguistically diverse Victorians
Victorians with CALD backgrounds have lower prostate cancer survival than Australian-born individuals, a study has found.
A team of Monash University researchers has investigated how culturally and linguistically diverse (CALD) backgrounds influence survival in those diagnosed with serious types of prostate cancer in Victoria.
The study, led by Dr Koku Tamirat and Dr Michael Leach from Monash Rural Health, and been published in the journal Cancer Medicine, of approximately 10,000 patients participating in the Victorian Prostate Cancer Outcomes Registry, or PCOR-Vic, was conducted over a 15-year period: February 2009 to February 2024.
The study found that, if CALD individuals diagnosed with prostate cancer in Victoria could have their healthcare needs met to the same extent as Australian-born individuals diagnosed with prostate cancer in Victoria, then they would no longer die earlier than their Australian-born counterparts.
Compared with Australian-born individuals, CALD individuals experienced significantly greater mortality following a diagnosis of high-risk, regional or metastatic prostate cancer. While Australian-born individuals had a 71% chance of surviving five years after diagnosis and a 55% chance of surviving ten years after diagnosis, CALD individuals had only a 66% chance of surviving five years after diagnosis and a 49% chance of surviving ten years after diagnosis.
The increase in deaths among CALD individuals related to the fact that, compared with their Australian-born counterparts, CALD individuals had different characteristics at the time of diagnosis. In particular, CALD individuals were diagnosed later at older ages than Australian-born individuals. Upon adjusting results for the effects of factors such as age at diagnosis, the type of prostate cancer diagnosed, and the type of diagnosing hospital, the researchers found that CALD individuals had significantly lower mortality than Australian-born individuals. In this study individuals from CALD backgrounds were defined as people born in mainly non-English-speaking countries across Europe, Asia, Africa, the Americas and elsewhere in Oceania.
Co-author Dr Michael Leach from Monash Rural Health spoke about the study’s results.
“Our results say a lot about healthcare accessibility in Victoria, Australia,” Dr Leach said.
“The results essentially mean that, while individuals from CALD backgrounds die sooner after a diagnosis of serious prostate cancer than Australian-born individuals, they would in fact survive serious prostate cancer longer than Australian-born individuals if they were to have equal ages at diagnosis, the same rates of earlier prostate cancer diagnosis, equitable access to private healthcare, and certain other points of equivalence with Australian-born individuals.”
He added that access to private healthcare is important because private hospitals tend to provide more timely cancer care than public hospitals. Earlier prostate cancer diagnosis is important because, if prostate cancer is detected and diagnosedbefore it has a chance to spread beyond the prostate to other organs, then an individual’s risk of death will be reduced. And age at diagnosis is important because, compared with older people, younger people are typically healthier and have lower risk of dying from prostate cancer and other causes.
Lead author Dr Tamirat provided contextual information on cultural and linguistic diversity.
“Our findings highlight the importance of Australian documents like the Australian Cancer Plan and Optimal Cancer Care Pathways, which address the importance of addressing CALD individuals’ healthcare needs through an equity lens,” he said.